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Ask Anthony Bray, MD Your Own Question

Anthony Bray, MD, Doctor

Category: Health

Satisfied Customers: 7460

Experience: 14 years as clinician in the field of Family Practice

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I had some blood work done and most of the results came back

Customer Question

I had some blood work done and most of the results came back low. I have suffered from heavy period all of my life; I am 56 years old and haven't gone through menopause yet. The doctor wants me to have a colonoscopy because he thinks I'm bleeding elsewhere and that low blood levels couldn't come from just my periods.
WBC 4.5-RBC 4.11- Hemo 8.6-Heat 27.7- MCV 67=MCH 20.9- MCHC 30.9- RDW 20.4
Platelets 312- Neutrophile 61- Lymphs 29- Monocytes 7- Eos 2- Basos !- Neutrop Absolute 2.7- Lymphs Absolute 1.3- Monocytes Absol 0.3-EOS Absol 0.1- Baso Absol 0.0
I don't know what most of these abbreviations stand for could you please explain them to me. And, do you feel that the low levels must be from other sources? I do have a colonoscopy scheduled.
What is ALT (SGPT) 54 High. Carbon Dioxide 18,low TSH 1.470 what are the effects of these low results?

You are anemic and the results would fit with iron deficiency anemia. The low MCV(mean cellular volume ) would fit with iron deficincy anemia.

Anthony Bray MD :

Iron deficiency anemia would be consistent with blood los being the cause of your anemia. We do tend to suspect a GI source as being the most likely to cause this but heavy enough periods might as well.

Eos = eosinophils = cellls that are related to allergy response and also fighting parasitic infections. Monocytes and basos = other subtypes of white cells.

Anthony Bray MD :

ALT is a liver enzyme. TSH = Thyroid Stimulating Hormone (normal range for this is 0.4 to 4.5 mcIU/L) so your value is within normal limits on this.

JACUSTOMER-nonjemfu- :

I have been anemic all of my life so nothing new there.

JACUSTOMER-nonjemfu- :

ALT is high so should I be worried and what can I do for it? Also what about the carbon dioxide level?

Anthony Bray MD :

OK, well continued iron would be indicated and follow up at least. I would agree with the need to rule out GI as a contibutor to this..

JACUSTOMER-nonjemfu- :

I have an appointment for the first visit for the colonoscopy on Nov 15.

Anthony Bray MD :

The ALT is only mildly elevated. Avouid too much alcohol and much Tylenol as these can cause this to go higher. Generally it is not until this is >2 to 3 times the upper limit that it is concerning. It can be caused by fatty liver which is associated with high cholesterol or triglyceride numbers. Too much fat storage within the liver can casue this too in other words.

Anthony Bray MD :

The CO2 relates to the body's acid/base balance. Too low on this value may be compatible with metabolic acidosis. This can get confusing in that as part of a metabolic profile this refers to the presence of bicarbonate while as part of a blood gas reading it refers to actula carbon dioxide dissolved in blood.

JACUSTOMER-nonjemfu- :

I don't drink at all and I usually take ibuprofen. But my cholesterol was 208 and my trig was 162 so I will be watching my diet. What are your thoughts on the DASH diet?

Anthony Bray MD :

The DASH diet is helpful for high blood pressure. Is this an issue for you as well?

Anthony Bray MD :

You're cholesterol and triglycerdise numbers are not that high. Do you take any other meds?

JACUSTOMER-nonjemfu- :

Can you explain the metabolic acidosis in english? lol Does that mean my body is acidic? So what can I do for that?

Anthony Bray MD :

This may be caused by your kidneys. The source of this may be sought and if it is an ongoing thing or just transient..

Anthony Bray MD :

It might be pursued further in order to determine the cause. Your blood gas would give further information on the pH of the blood, oxygen and CO2 content as well as bicarbonate and this would be a better platform from which to make further assesment..

Anthony Bray MD :

The low CO2 on this report could be compensated or a compensation for something else going on..

JACUSTOMER-nonjemfu- :

I have had blood pressure problems today it was 142/76 and he gave me a prescription for Amlodipine 5 mg. I haven't been able to take most of the mediations because I am allergic to sulfa and have had reactions to the medication. He prescribed Bystolic but it made my ankles swell up so I discontinued it.

JACUSTOMER-nonjemfu- :

The only other med I take is Claritin.

JACUSTOMER-nonjemfu- :

What could be the something else with the CO2 level?

Anthony Bray MD :

OK well there is rarely anything adverse with claritin. The history of high blood pressure could tie in with your renal function as well.

JACUSTOMER-nonjemfu- :

Would the blood gas be on my lab results? What would I look under?

JACUSTOMER-nonjemfu- :

So the high blood pressure could be causing problems with my kidneys?

Anthony Bray MD :

Low CO2 could be part of compensation for respiratory alkalosis. It could be caused by renal tubular acidosis ..a kidney dysfunction problem.

Anthony Bray MD :

No, a blood gas you would know as these are generally done at the hospital and they have to get this from an artery rather than a vein. The sample is placed on ice and run in the hospital lab within a few minutes.

JACUSTOMER-nonjemfu- :

Respiratory alkalosis?

Anthony Bray MD :

A blood gas is not part of a routine metabolic profile.

JACUSTOMER-nonjemfu- :

So going back to the acidosis-what can I do for that?

Anthony Bray MD :

Hyperventilation removes too much CO2 (an acid)((the GAS in this instance)) and this makes the blood more alkaline(higher pH). The kidneys may compensate by elimanting more of the bicarbonate ion (( CO2 as the bicarbonate ion in this instance)) which helps to move the pH back toward normal.

Anthony Bray MD :

It is not as simple as telling you to do anything at this point because the rest of the picture is missing. The blood gas and other information is need to complete the picture. There are several possible diagnoses and thus solutions...

Anthony Bray MD :

The urine may also need to be evaluated for excreation of salts and bicarbonate for example..

JACUSTOMER-nonjemfu- :

What exactly do you mean hyperventilating? I think of it as breathing into a bag and I have never done that.

Anthony Bray MD :

Hyperventilation in the sense of breathing deeper or more rapid than needed for the body's needs. In this the CNS might be driving an abnormal respiratory drive. This would produce a relatively high oxygen content, low carbon dioxide and high pH. If you had respiratory alkalosis then the metabolic acidosis can be a mechanism for compensation for this. This is a difficult topic to explain and I apologize for this difficulty...

JACUSTOMER-nonjemfu- :

CNS?

Anthony Bray MD :

Central nervous system..

JACUSTOMER-nonjemfu- :

Don't quite understand what you just wrote......Thanks Dr. Bray I think we have covered everything I wanted to know. Good night.

Anthony Bray MD :

Further work up will most likely be needed for this finding. The metabolic acidosis may be caused by a type of renal problem known as renal tubular acidosis. This may be the problem although other explanations for the CO2 bing low are there...

Anthony Bray MD :

OK , good night. Let me know if there is anuthing further that I can do for you. Best regards,

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